Tactical Combat Casualty Care (TCCC) – Core Concepts

32 vocabulary flashcards summarizing key TCCC terms, concepts, equipment, pathologies, priorities, and evidence, enabling focused study for the upcoming exam.

Tactical Combat Casualty Care (TCCC)

Evidence-based military guidelines that integrate medical treatment with tactical requirements to treat casualties, prevent additional casualties, and complete the mission.

Care Under Fire (CUF)

The first TCCC phase in which lifesaving care is provided while engaging the enemy; priorities are fire superiority, moving to cover, and rapid hemorrhage control (tourniquet).

Tactical Field Care (TFC)

The second TCCC phase that begins once casualties and rescuers are in relative safety; allows more thorough assessment and interventions (airway, breathing, meds, etc.).

Tactical Evacuation Care (TACEVAC)

The third TCCC phase; medical care given during transport to higher echelons (vehicle, aircraft, boat) with additional resources available.

Extremity Hemorrhage

Most common cause of preventable battlefield death; rapid arterial bleeding from an arm or leg that requires immediate tourniquet application.

Junctional Hemorrhage

Severe bleeding at the groin, axilla, or neck where standard limb tourniquets cannot be applied; often produced by IEDs.

Tension Pneumothorax

Second leading cause of preventable combat death; trapped air collapses a lung and compresses the heart—treated with needle thoracotomy.

Airway Trauma

Relatively infrequent but often preventable combat fatality category that may need positioning or surgical airway in TFC.

Committee on Tactical Combat Casualty Care (CoTCCC)

42-member DoD / civilian panel that reviews data and updates TCCC guidelines; all members have deployment experience.

Combat Application Tourniquet (C.A.T.)

CoTCCC-recommended limb tourniquet featuring a Velcro strap and windlass; standard issue for U.S. forces.

SOF-T (Special Operations Forces-Tourniquet)

CoTCCC-approved tourniquet with a buckle and windlass favored by many special-operations medics.

Emergency & Military Tourniquet (EMT)

A third CoTCCC-recommended limb tourniquet option used by some units.

High-and-Tight Placement

Tourniquet strategy when the exact bleeding site is unclear—apply as proximal as possible on the injured limb, over the uniform.

Hemostatic Agent – Combat Gauze

Kaolin-impregnated gauze used to control bleeding when a tourniquet cannot be applied or after tourniquet removal in TFC.

Junctional Tourniquet

Mechanical device designed to compress vessels at the groin or axilla and control junctional hemorrhage.

XStat

Injectable sponges that rapidly expand to tamponade deep, narrow-track wounds, especially in junctional areas.

Pelvic Binding Device

External compression wrap applied to suspected pelvic fractures to reduce bleeding and stabilize the pelvis.

Hypotensive Resuscitation

Fluid strategy that avoids raising blood pressure to normal levels—prevents clot disruption until surgical control is possible.

Tranexamic Acid (TXA)

Antifibrinolytic medication given within 3 hours of injury to reduce hemorrhage-related mortality on the battlefield.

“Triple Option” Battlefield Analgesia

TCCC pain-control concept: (1) Oral acetaminophen/celecoxib, (2) Oral transmucosal fentanyl citrate (OTFC), (3) Ketamine IM/IV.

Needle Thoracotomy (Needle Decompression)

Rapid insertion of a 14-gauge or larger needle into the chest to relieve tension pneumothorax in the field.

Fire Superiority

Tactical principle that the best medicine in a firefight is achieving dominant suppressive fire to prevent additional casualties.

Signs of Life-Threatening Bleeding

Pulsing flow, pooling blood, soaked clothing, ineffective bandages, visible amputation, or shock after prior bleeding.

Tourniquet Mistakes to Avoid

Delayed use, insufficient tightening, use for minimal bleeding, placing over joints/gear, failing to apply a second tourniquet, or periodically loosening it.

Prehospital Military vs Civilian Trauma

Combat care faces hostile fire, darkness, environmental extremes, limited gear, long evacuation times, and different wounding patterns.

Different Trauma – Different Strategies

Combat and civilian injuries differ; optimal battlefield care requires collaboration between trauma surgeons and combat medics.

Objectives of TCCC

1) Treat the casualty, 2) Prevent additional casualties, 3) Complete the mission.

Early 2000s Battlefield Care Deficiencies

No limb or junctional tourniquets, no hemostatics, large-volume crystalloids, IM morphine, routine intubation, and IV cut-downs.

Evidence for TCCC Tourniquets

Preventable-death rate fell from ~7.8% to 2.6% of combat fatalities in OEF/OIF after widespread tourniquet adoption (67% decrease).

Care Under Fire Priorities

Return fire, take cover, direct self-aid, move casualties to cover, suppress enemy, and control massive extremity bleeding.

C-Spine in Penetrating Trauma

Spinal immobilization is generally NOT required for gunshot or shrapnel wounds to the head/neck because cord damage is already present or unlikely to worsen.

Casualty Movement Rescue Plan

Consider nearest cover, best carry method, rescuer risk, casualty weight, distance, and use of suppression or smoke when moving casualties under fire.

Burn Prevention in CUF

Remove casualties from burning vehicles/structures promptly and extinguish flames with non-flammable fluids, smothering, or rolling.